Massive posterior fossa tuberculous abscess developing in a young child treated for miliary tuberculosis: Possible role of very rapid acetylation of isoniazid

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dc.contributor.authorSchoeman J.F.
dc.contributor.authorMorkel A.
dc.contributor.authorSeifart H.I.
dc.contributor.authorParkin D.P.
dc.contributor.authorVan Helden P.D.
dc.contributor.authorHewlett R.H.
dc.contributor.authorDonald P.R.
dc.date.accessioned2011-05-15T16:17:39Z
dc.date.available2011-05-15T16:17:39Z
dc.date.issued1998
dc.description.abstractA 21-month-old infant presented with acute obstructive hydrocephalus due to a large tuberculous abscess in the posterior fossa 3 months after starting treatment for miliary tuberculosis. Insertion of a ventriculo-peritoneal shunt resulted in some clinical improvement but subsequent neurological deterioration occurred due to massive enlargement of the tuberculous abscess despite apparently adequate antituberculosis therapy. Repeated drainage procedures of the abscess eventually resulted in resolution and clinical improvement. As part of the workup for poor weight gain and the unusual clinical course, the patient's acetylation status for isoniazid was determined and found to be very rapid. Doubling the daily dose of isoniazid was followed by a dramatic weight increase and further clinical improvement. Decreasing the load of tuberculous antigen by draining the abscesses and increasing the pulse exposure of isoniazid is the best possible explanation for the clinical improvement finally seen in this patient.
dc.description.versionArticle
dc.identifier.citationPediatric Neurosurgery
dc.identifier.citation29
dc.identifier.citation2
dc.identifier.issn10162291
dc.identifier.urihttp://hdl.handle.net/10019.1/14313
dc.subjectisoniazid
dc.subjectpyrazinamide
dc.subjectrifampicin
dc.subjectabscess drainage
dc.subjectacetylator phenotype
dc.subjectarticle
dc.subjectbrain abscess
dc.subjectbrain ventricle peritoneum shunt
dc.subjectcase report
dc.subjectchild
dc.subjectdose response
dc.subjectdrug acetylation
dc.subjectfemale
dc.subjecthuman
dc.subjecthydrocephalus
dc.subjectmiliary tuberculosis
dc.subjectposterior fossa
dc.subjectpriority journal
dc.subjectAbscess
dc.subjectAcetylation
dc.subjectAntitubercular Agents
dc.subjectBrain Abscess
dc.subjectFemale
dc.subjectHumans
dc.subjectHydrocephalus
dc.subjectInfant
dc.subjectIsoniazid
dc.subjectTuberculosis, Miliary
dc.titleMassive posterior fossa tuberculous abscess developing in a young child treated for miliary tuberculosis: Possible role of very rapid acetylation of isoniazid
dc.typeArticle
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